Treat thigh fracture at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$13,873.20
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$23,122.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$2,536.15 with Highmark BCBS of PA vs $18,497.60 with Private Health Care Systems — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $2,536.15 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $3,675.51 | ↓ -74% |
| Highmark BCBS of PA | Managed Care - Social Mission | $5,646.83 | ↓ -59% |
| Aetna | Medicare | $5,780.50 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $7,340.43 | ↓ -47% |
| Highmark BCBS of PA | Managed Care | $7,562.49 | ↓ -45% |
| United Healthcare | Compass Exchange | $7,630.26 | ↓ -45% |
| UPMC Health Plan | CHIP | $8,092.70 | ↓ -42% |
| Aetna | Neighborhood Network | $8,115.82 | ↓ -42% |
| Aetna | EBR FI | $8,786.36 | ↓ -37% |
| Aetna | Home Depot Employer Group | $8,832.60 | ↓ -36% |
| Aetna | NBR ASO/FI | $9,017.58 | ↓ -35% |
| United Healthcare | All Business | $9,017.58 | ↓ -35% |
| Cigna | NBR ASO/FI | $9,017.58 | ↓ -35% |
| Cigna | New Business ASO | $9,017.58 | ↓ -35% |
| Cigna | Commercial | $9,248.80 | ↓ -33% |
| Aetna | EBR ASO | $9,248.80 | ↓ -33% |
| Cigna | EBR | $9,248.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $9,830.89 | ↓ -29% |
| UPMC Health Plan | Commercial | $11,341.34 | ↓ -18% |
| InterGroup | PPO | $11,561.00 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $11,561.00 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $12,717.10 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $12,717.10 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $15,124.97 | ↑ +9% |
| Coventry/First Health | Commercial | $16,185.40 | ↑ +17% |
| Private Health Care Systems | PPO | $18,497.60 | ↑ +33% |
Visitor-reported prices
Comments
Treat thigh fracture at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Williamsport | Williamsport | $15,467.40 | $993.28 – $4,060.16 |
| Uniontown Hospital | Uniontown | $3,127.50 | $7,033.14 – $16,387.22 |
| UPMC Memorial | York | not published | $1,016.56 – $3,594.55 |
| UPMC Mercy | Pittsburgh | not published | $2,512.22 – $3,886.12 |